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<br />Statement to Taxing Officials_
<br />Re~~t ed Form-n ber 19, 96 P scribed by 9tat Tax Commtssioner The Augusetq. Co., Grand Isia.ntl; Nebr.
<br />1 Form 1R-I852 17iis Statement is Confidential and Available
<br />(Revised) to Taxiag Officials Only
<br />This form,.pursuant to Section 76-211 R. R. S. 1943, as amended by the 75th Session of the Nebraska
<br />Legislature,. must be completed by every Grantee and filed at the time each .deed of real estate is pre-
<br />rented for recording.
<br />Glen M. Stewart and Francisco P. Roses and Behita
<br />I. Grantor~a.lrhteen Stewart husband Grantee T. Roses, husband and wife..
<br />ana wife
<br />Addracs Grand Islam, Nebraska pd~~ Grand Island, bTebraska
<br />Type. of Instnuilent Stzrvicarsh~_ Date of Instrument-
<br />Warranty Deed
<br />lI. Legal,Description: The Northerly Fifty-T«~a (52} fezt of that certain £ul1 tote
<br />#ormed by Fractionat Lot Eight ($) ir. Fractional Block Six (5) in John
<br />Voitle!s Addition, and its complement, tractional Lnt Eight (8} in Frac-
<br />tionai Block CSne Hundred .Thirty (130) of LTnian Pzcific Raiiwa}r Company's
<br />Second Addition, both t.eino additions to the City. of Grand Isiarid, Nebraska
<br />ein a .rectangular tract of <;round having frontage of 52 £eet on Vine Street
<br />I1T. ~nsl~eratwn ° ,rod a depth of 6b £eet.
<br />Six Thousand Five Hundred Dollars ($6, 500.00)
<br />A_ Total Consideration paid or to be paid{cash, mortgages,
<br />property traded, assumed liabilities, etc.) $_6. 500, 00
<br />B. Personal Property Included in Purchase $-.-- -.--_------
<br />C. Leases and Easements Included in Purchase. $__
<br />D.` Other Itemsincluded in Purchase $~-~_____.,_,
<br />E. Ig Contract Sale, Total Interest & Carrying Charges S_._ ._
<br />TOTAL'CONSIDERATIONS $__b.__500w00
<br />N. In cases of gift, or any deed with nominal consideration, I hereby certify that the current market
<br />value of the property ransferred is $_. ,_ _~:-
<br />V. Check: applicable. statement
<br />.Sale or Transfer Between'Relatives.
<br />Sale of Property in Connection with Foreclosure, Bankruptcy,
<br />Condemnation: or .Other Such Legal Action.
<br />^ Purchase for different use than. by Previous Chvner
<br />(For Example-Agricultural to Industrial Use)
<br />o Other, Explairi:_~g n t a r a l T r i n c~ r ~o r
<br />true and correct, ersigned, having personal knowledge of" this transacu'oli, rlertiPy that the foregoing is
<br />Signature , s___ : ; ` _~_~__.Y-----_,,
<br />t '~~M GRiMMINGER
<br />Capacity '<. Ekitor'n~ at Law
<br />CERTIFICATION.
<br />OFFICIAL USE: Book Page
<br />Property Type: SU, MU, SS, I!3S, I, C, A_.. _ __.~_. _- ------_.__.~__
<br />Tf Agricultural: Total-.Acres-..___._-~ Irrigated Acres _,__
<br />Type.of IrrigatiocL:_,_._~..:_~___-__
<br />Assessed Values _.-__-_--
<br />-.Land $~_r.--- .~
<br />Improvements $_ ___.~_
<br />-- --- TOTAL $--,--------
<br />This .Sale should be used in a Sales A,SSessment Ratio Yes [] No
<br />(plain "I`7o" answer on reverse side)..
<br />County---- __.____,~_ ----- -- -_
<br />County Identification_.__ __.__ _ _ _ ,
<br />
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